Wagner, Thomas

Wagner, Thomas is an individual health care provider with primary practice located at 34960 Center Ridge Rd , N Ridgeville OH 44039-3183. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wagner, Thomas can be contacted via phone (440) 353-3433.

Contact Information

Primary practice address
34960 Center Ridge Rd N Ridgeville OH 44039-3183
Fax: (440) 353-3431
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34007204 Ohio

Profile Details

NPI number 1669464673
LBN Legal business name Wagner, Thomas
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Nov 6th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669464673 NPPES
Ohio Other P00103662 RR MEDICARE
Ohio MEDICAID 2253832 RR MEDICARE

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